- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $2,238.72 / $3,801.89
| Facility | | $251.19 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $208.93 / $407.38
| Professional | | $102.33 | $208.93 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $3,981.07 / $19,498.45
| Facility | | $251.19 | $3,981.07 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $239.88 / $1,548.82
| Professional | | $109.65 | $239.88 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $154.88 / $354.81
| Facility | | $154.88 | $154.88 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $1,737.80 / $1,737.80
| Professional | | $630.96 | $1,737.80 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $478.63 / $2,691.53
| Facility | | $446.68 | $478.63 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $245.47 / $501.19
| Professional | | $120.23 | $245.47 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $380.19 / $7,079.46
| Facility | | $100.00 | $380.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $371.54 / $537.03
| Professional | | $263.03 | $371.54 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $3,801.89 / $9,772.37
| Facility | | $524.81 | $3,801.89 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $263.03 / $630.96
| Professional | | $120.23 | $263.03 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $3,981.07 / $19,498.45
| Facility | | $251.19 | $3,981.07 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $239.88 / $1,548.82
| Professional | | $109.65 | $239.88 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $3,890.45 / $9,120.11
| Facility | | $1,071.52 | $3,890.45 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $234.42 / $575.44
| Professional | | $112.20 | $234.42 | $575.44 |